Osteopenia vs osteoporosis
Osteopenia means bone density somewhat below the reference range without reaching the osteoporosis threshold. It is not a disease in itself and does not always require medication.
Risk factors
Age, early menopause, previous fractures, family history of hip fracture, long-term glucocorticoids, low body weight, smoking and alcohol.
Diagnosis
Clinical history, DXA, risk tools such as FRAX, vertebral fracture assessment and investigation of secondary causes where appropriate.
Treatment
Exercise, fall prevention, adequate calcium and vitamin D and, when risk justifies it, antiresorptive or anabolic medication.
When to seek advice
After a fragility fracture, with an abnormal DXA result or significant risk factors.
Related content
A hot, very painful and swollen joint, especially with fever, requires urgent medical attention.